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在治疗焦虑和抑郁症的认知行为疗法后,减轻症状对功能改善的重要性:因果调解分析
Otto R F Smith1,2,3, Leif E Aarø1, Marit Knapstad1
1Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.
Psychotherapy and psychosomatics
|May 26, 2023
概括
对焦虑和抑郁症的认知行为疗法 (CBT) 显著改善了功能. 在CBT中早期减轻症状,特别是在抑郁症中,可以促进患者的长期功能改善.
科学领域:
- 精神病学和心理健康 精神病学和心理健康
- 临床心理学 临床心理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 对焦虑和抑郁症的认知行为疗法 (CBT) 中症状改善和功能收益之间的精确时间关系尚不清楚.
- 检查中介途径的高质量研究,即早期症状变化影响后来的功能,很少.
研究的目的:
- 调查CBT对12个月症状和功能的影响是否与其在6个月后的影响有关.
- 区分初始症状与功能改善对后期结果的影响.
主要方法:
- 随机对照试验比较初级精神卫生保健CBT (n=463) 与通常治疗 (n=215).
- 在基线,6个月和12个月评估抑郁症状 (PHQ-9),焦虑 (GAD-7) 和功能 (WSAS).
- 利用潜在的结果和反事实框架来得出直接/间接的影响.
主要成果:
- 认知认知疗法的12个月对功能的影响在很大程度上介于6个月对抑郁症状 (51%) 和功能 (39%) 的影响.
- 12个月对抑郁症状的影响主要是由6个月抑郁症状改善 (70%) 驱动的.
- 12个月的焦虑改善部分归因于6个月的焦虑 (29%) 和功能 (10%) 的改善.
结论:
- 认知认知疗法的晚期干预对功能的影响在很大程度上可以通过初始症状的减少来解释,特别是在抑郁症中.
- 这些发现强调了针对症状作为初级保健CBT的关键结果的重要性.
- 在早期CBT阶段的症状缓解对于在焦虑和抑郁症患者中实现持续的功能恢复至关重要.
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